Provider Demographics
NPI:1144997578
Name:HENSLER, TRACY LEA (PHARMD)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LEA
Last Name:HENSLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-6505
Mailing Address - Country:US
Mailing Address - Phone:570-320-8794
Mailing Address - Fax:570-320-8796
Practice Address - Street 1:201 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6505
Practice Address - Country:US
Practice Address - Phone:570-320-8794
Practice Address - Fax:570-320-8796
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist